<style>
    input {
        width: 200px;
    }
    #ckbAgree {
        width: 20px !important;
    }
</style>
<div id="formsignup">
	<fieldset style="float:right; margin-right:30px; width:25%;padding:15px 10px 20px 10px">
		<legend>Quyền lợi của thành viên</legend>
	<?php echo $qltv->contents ?>
		
	</fieldset>
	
    <form method="post" action="<?php echo site_url('sigup') ?>" id="frmSignUp" name="frmSignUp">
		
	<fieldset style="width:55%; border:#999999 1px solid; padding:15px 40px 20px 10px; margin:15px 0px 0px 50px;">
	
	<legend>Thông tin đăng nhập</legend>
	<span style="color:red; font-weight: bold;"><?php echo notify_get_messages('captcha') ?></span>
	 <p style="color: #999999; margin:5px 0px 5px 10px;">
		<i>Trường có dấu <span style="color:red;">*</span> cần phải có giá trị </i>
	 </p>
	 
	<table name="tblSignUp" id="tblSignUp">
              <!--DWLayoutTable-->
                <tbody><tr>
                  <td height="15" valign="top" colspan="2">
				 	 <span >
					 Email<span style="color:red;"> *</span> 
					 </span>		
				  </td>
                </tr>
				
                <tr>
                  <td height="21" width="237" valign="top">
                    <span class="uibutton">
				  	<input type="text" maxlength="150" value="<?php echo set_value("txtEmail");?>" id="txtEmail" name="txtEmail" /></span>
				  </td>
				  
                 <td width="215" valign="top">
				 <div style="margin-left:30px;" id="email_error">
									</div>
					
				 </td>
				 
                </tr>
				
                <tr>
                  <td height="26" valign="top" colspan="2">
				  	<span style="color: #999999;">
						<i>Mọi thông tin liên quan đến tài khoản của bạn sẽ được gửi qua email này</i> 
					</span>
				  </td>
                </tr>
				
                <tr>
                  <td height="16" valign="top" colspan="2">
					 <span>
					  	Mật khẩu <span style="color:red;">*</span>
					  </span> 
				  </td>
                </tr>
                
                <tr>
                  <td height="31" valign="top">
                  <span class="uibutton">
				  	 <input type="password" maxlength="50" id="txtPassword" name="txtPassword" />
                  </span>  
				  </td>
				  
                  <td valign="top">
				  	<div style="margin-left:30px;" id="errorNewPass"></div>
				  </td>
                </tr>
				
                <tr>
                  <td height="16" valign="top" colspan="2">
				  	<span>
						Xác nhận mật khẩu <span style="color:red;">*</span>
					</span> 
				  </td>
                </tr>
                
                <tr>
                  <td height="26" valign="top">
                  <span class="uibutton">
				    <input type="password" maxlength="50" id="txtConPassword" name="txtConPassword" /> </span>
				  </td>
				  
                  <td width="70%" valign="top">
				  	<div style="margin-left:30px;" id="errorConfirmPass"></div>
				  </td>
                </tr>
                
    </tbody></table>
			
	</fieldset>
		
	<fieldset style="width:55%;border:#999999 1px solid; padding:15px 40px 20px 10px; margin:15px 0px 0px 50px;">
		<legend>Thông tin cá nhân</legend>

		<p style="color:#999999;margin:5px 0px 10px 10px;">
			<i>Điền chính xác và đầy đủ thông tin cá nhân của bạn để đảm bảo quyền lợi từ thông tin và dịch vụ tại Hiếu Học </i>  
		</p>	
		
		<table width="464" name="tblPersonalInfo" id="tblPersonalInfo">
              <!--DWLayoutTable-->
                <tbody><tr>
                  <td height="16" width="279" valign="top">
				  <span>
				  	Họ và Tên  <span style="color:red;">*</span>
				  </span>
				  </td>
                </tr>
				
                <tr>
                  <td height="30" valign="top"><span class="uibutton">
				  		<input type="text" maxlength="100" value="<?php echo set_value("txtFullName");?>" id="txtFullName" name="txtFullName" /></span>
				  </td>
				  
                  <td valign="top" colspan="3">
				  	<div style="margin-left:20px;" id="fullName_error"></div>
				  </td>
                </tr>
				
				 <tr>
                  <td height="16" width="279" valign="top">
				  <span>
				  	Ngày sinh 
				  </span>
				  </td>
                </tr>
				
                <tr>
                  <td height="30" valign="top">
				  
				 	<span class="uibutton">	
				        <select style=" width:15%;" id="day" name="day">
                            <?php for($i = 1; $i <= 31; $i++) { ?>
							 <option value="<?php echo $i ?>" <?php echo set_select('day', $i); ?> > <?php echo $i ?> </option>
                            <?php 
                            }
                             ?>
						</select>
                    </span>
				<span class="uibutton">	
    			 	<select style="width:15%;" id="month" name="month">
                        <?php for($i = 1; $i <= 12; $i++) { ?>
    						<option value="<?php echo $i ?>" <?php echo set_select('month', $i); ?>><?php echo $i ?></option>	
                        <?php } ?>    						
    				</select>
				</span>
                <span class="uibutton">	
    			 	 <select style="width:20%;" id="year" name="year">
                        <?php 
                        for ($i = 1960; $i < date('Y') - 13; $i++) {
          
                         ?>
    				 		<option value="<?php echo $i ?>" <?php echo set_select('year', $i); ?>> <?php echo $i ?> </option>
                       <?php 
                        }
                        ?>    			
    				</select>
				 </span>
                 
				  <span style="margin:0px 0px 0px 10px;"><span style="color:red">*</span></span></td>
				  
                  <td valign="top" colspan="3">
				  	<div style="margin-left:20px;" id="fullName_error"></div>
				  </td>
                </tr>
				
                <tr>
                  <td height="16" valign="top" colspan="3">
				  	<span>
				  		Trình độ học vấn
					</span>
				  </td>     
                </tr>
				
                <tr>
                  <td height="30" valign="top" colspan="3">
                      <select id="slEducation" name="sltEducation">  
                      <?php 
                      foreach ($eduList as $row) {
                      
                       ?>            
							<option value="<?php echo $row->id ?>" <?php echo set_select('sltEducation', $row->id); ?>> <?php echo $row->title ?>	</option>	
					 <?php 
                        }
                      ?>								
					  </select>                   
				  </td>
				  
                </tr>
				
                <tr>
                  <td height="16" valign="top" colspan="3">
				  	 <span>	
						Ngành nghề bạn đang học hoặc quan tâm
					 </span>
				  </td>
                </tr>
				
                <tr>
                    <td height="30" valign="top" colspan="2">
                      <select onchange="checkMajor();" id="major" name="major">
                      *:
                   <?php 
                   foreach ($job as $row) {
                   
                   
                    ?>   
							<option value="<?php echo $row->id ?>" <?php echo set_select('major', $row->id); ?>>
						  <?php echo $row->title ?>
                          </option>	
												  
					<?php 
                    }
                     ?>
					 </select>  
					   
				   </td>
                    <td valign="top" colspan="2">
						<div id="major_error"></div>
					</td>
               </tr>	 
			   
               <tr>
                  <td height="30" valign="top" colspan="2">
				  <div id="otherMajor">
				  		Ngành Nghề Khác
					     <br />
					<input type="text" maxlength="150" value="<?php echo set_value('otherMajor') ?>" id="txtotherMajor" name="otherMajor" /> 
				  </div>                
				  </td>
            
			        
				  <td valign="top" colspan="2">
					<div style="margin-left:15px; margin-top:20px;" id="errorMajor"></div>	
				  </td>
              </tr>
				
                <tr>
                  <td height="16" valign="top" colspan="3">
				  	<span>
				  		Nơi làm việc/sinh sống
					</span>
				  </td>
				    
                </tr>
				
                <tr>
                   <td height="30" valign="top" colspan="3">
                 <select  id="city" name="city">
                 *:
                 <?php 
                 foreach ($provinces as $row) {
                 
                 
                  ?>
					<option value="<?php echo $row->id ?>" <?php echo set_select('city', $row->id); ?>> <?php echo $row->title ?></option>	
                 <?php 
                 }
                  ?>       
											     
                  </select>                    
				  </td>
                </tr>
				
                <tr>
                    <td height="24" valign="top" colspan="3">
					
					 <div id="otherCity">
						Nơi khác<br />
				<input type="text" maxlength="200" value="<?php echo set_value('otherCity') ?>" id="txtotherCity" name="otherCity" />          		
					</div>
					</td>
                    <td valign="top">
						<div style=" margin-left:5px; margin-top:15px;" id="errorCity"></div>
					</td>
					
                </tr>	
					
    </tbody></table>
	
	</fieldset>
		<br /><br />
		<span style="margin:0px 0px 0px 80px;">
			Mã bảo mật <span style="color:red">*</span>:
		</span>
		
					<br />
		<span style="margin:20px 0px 10px 80px;">
         <?php echo $imgCaptcha ?>
		</span>	 <br />			          
		 <span style="margin:20px 0px 10px 80px;"  class="uibutton">

		 	<input type="text" maxlength="5" id="captcha" name="captcha" />
            
		</span>				
		<br /><br />
		
	  <span style="margin:30px 0px 0px 80px;" class="uibutton">	
			<input type="checkbox" id="ckbAgree" value="1"  name="ckbAgree" <?php echo set_checkbox('ckbAgree', '1'); ?> />	
          Tôi đã xem <a id="thoathuan" href="javascript:void(0)">thoả thuận sử dụng</a> của Hiếu Học và đồng ý với các quy định đó		</span>	
		<br />
		<br />	
			
		<input type="submit" class="Button" style="margin:10px 0px 20px 300px;" value="Đăng ký" name="btnSubmit" />	        
							
      </form>      
    </div>
    